Indonesia hopes to win over medical tourists with overhaul of healthcare sector - a special report from The Straits Times

The Indonesian government is moving to contain the flow of affluent citizens seeking treatment abroad. - AFP

JAKARTA, Jan 8 (The Straits Times/ANN): Indonesian retiree Johabun has consulted a Singaporean nephrologist for his chronic kidney disease since 2008.

Prior to the pandemic, he used to meet the physician once a year, spending around $3,000 for consultation and medicines - a sum that has risen only slightly over the years.

"I had to go to Singapore because five local doctors I consulted here could not prescribe medicines that suited me," the 64-year old Jakarta resident told The Straits Times. "If I could find one who could prescribe appropriate drugs, I wouldn't do that."

He claimed that all the medicines prescribed by the Indonesian doctors brought various unpleasant side effects, such as drowsiness, swollen eyes and frequent urination, while those prescribed by his Singaporean specialist did not.

"Singaporean doctors are really experts," Johabun said, noting that his nephrologist has also treated numerous Indonesians.

The Republic is among the countries most visited by Indonesians like Johabun for medical services in the belief they will get better treatment there than at local hospitals.

But following the Covid-19 restrictions that limited cross-border movements for nearly two years, the Indonesian government is moving to contain the flow of affluent citizens seeking treatment abroad, and instead develop the country's own destination for medical tourism.

It is constructing the Bali International Hospital in Sanur, slated as the country's first health-related special economic zone, and expects to finish the project in mid-2023.

Indonesia's state-owned enterprises will team up with US-based Mayo Clinic to develop the 300-room facility and provide various medical services, including cancer treatment.

In Singapore, the most-sought treatments for Indonesian patients are heart valve surgery, coronary artery bypass surgery, total knee replacement, cataract surgery, endoscopy and colonoscopy, according to MediSata Indonesia, which helps Indonesians get healthcare services in Singapore and Malaysia. The costs range from S$1,500 for an endoscopy to S$55,000 for coronary artery bypass surgery.

All these treatments are also available in Indonesia at far lower cost.

The Indonesian government estimates that some two million Indonesians travel overseas every year for medical check-ups, treatment and other medical services, spending around 97 trillion rupiah (S$9.2 billion).

Those who can afford overseas treatments do so because of a "lack of trust in the local system and infrastructure", according to a 2018 report from US management consulting firm Oliver Wyman.

It also lists a shortage of healthcare centres and medical talent as among the country's major challenges.

The world's fourth most populous nation of 270 million had only 4.65 doctors per 10,000 people in 2019, according to the World Health Organisation, lagging behind some of its South-east Asian peers.

Based on the latest data available, Singapore had 22.94 doctors per 10,000 population in 2016.

Hospital management expert from Bali-based Udayana University Ketut Suarjana said some Indonesian patients with severe diseases such as cancer turn to Singapore hospitals as they need advanced treatments unavailable in Indonesia.

Local doctors may refer these patients to their Singaporean counterparts.

"The hospitals have more sophisticated diagnostic equipment, supplementing the expertise of the doctors," he said, noting that the equipment helps physicians generate a more accurate diagnosis.

Some patients travel to Singapore to seek a second opinion, which can sometimes save them unnecessary interventions.

Batam resident Syamsul Bahrum, 59, consulted a few doctors in the Riau Islands and Jakarta about his diabetes before visiting Mount Elizabeth Hospital in Singapore in 2019.

The doctors there advised him to stop injecting himself with insulin as recommended by their Indonesian counterparts, and rely on medication instead.

“I have not used insulin since then,” said the assistant for economic and developmental affairs at Riau Islands provincial administration.

“I don’t need insulin as my diabetes can still be controlled by medication. Our doctors and Singaporean doctors have different views on this.”

Dr Ketut said that the partnership with Mayo Clinic will give the Bali hospital a boost in gaining much-needed international recognition.

“It’s very difficult if we just begin from scratch,” he said. “If we only build an international hospital supported by sophisticated equipment like those in Singapore, people are not necessarily willing to come.”

Public health expert Dicky Budiman underlined the importance of international accreditation to ensure the hospital can offer the best and most competitive services.

“(Its success) will depend on how we develop the quality (of services) and involve independent (accreditation) institutions to make sure the hospital can operate in line with our expectations and compete globally,” he told ST.

Health Minister Budi Gunadi Sadikin has said that apart from welcoming foreign investors, Indonesia will also encourage the entry of foreign health professionals to improve the quality of its hospitals as part of the effort to transform its healthcare services sector.

Johabun, meanwhile, said he would first consider the cost before deciding if he is willing to go local.

“If the hospital charges less, perhaps I will go there.” - The Straits Times/ANN

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